Cotton swabs cause thousands of ear injuries each year, study finds

When Vidya Raman’s son complained of water in his ear after a shower, she did something many mothers do. She grabbed a cotton swab.

But her pre-teen son jerked when she inserted the swab. Her son cried and there was blood in his ear.

The boy’s eardrum had been perforated.

“This minor thing, this minor accident, resulted in a major thing,” said Raman, of Northwest Columbus, Ohio.

Injuries such as this are common, according to a new study that shows an average of 34 children visit emergency departments every day with ear injuries caused by cotton swabs.

In 73 percent of cases, children or caregivers were attempting to clean their ears with swabs, a practice that doctors say is dangerous.

There is a misconception that cotton swabs are the perfect tool for cleaning the ear canal, said Dr. Kris Jatana, an associate professor at Ohio State University’s Wexner Medical Center and an otolaryngologist at Nationwide Children’s Hospital.

“We see several patients a day in my clinic alone that clean their ears in the home setting and use cotton-tip applicators to do so,” said Jatana, one of the study’s authors. “Unfortunately, this results in a lot of injury, particularly in younger children.”

The study reviewed U.S. emergency department data from 1990 to 2010 and found 263,338 ear injuries attributed to cotton swab use.

The report, recently published in the Journal of Pediatrics last month, shows that the youngest children had the highest rate of injury — 32.2 injuries per 100,000 children ages 0 to 3, compared with 21.7 injuries per 100,000 for ages 4 to 7, and 10.3 per 100,000 for ages 8 to 17.

In 77 percent of cases, children handled the cotton swab themselves.

The most common injury was eardrum perforation and a foreign object in the ear.

“These injuries are all preventable, and despite all the warning labels that many manufacturers put on products, it seems there still persists a misconception,” Jatana said. “Our hope is, through educational efforts, that we can help reduce these injuries across the United States.”

Dr. Erika Kube, an emergency physician who works for Mid-Ohio Emergency Services and OhioHealth, said parents should leave ear wax alone.

“Ear wax is normal and is supposed to be in your ear,” she said. “It serves an antimicrobial purpose and helps to keep the ear canal dry, so it’s not harmful.”

Researchers suggest more visible warnings on packaging, posting fliers at primary care facilities, airing public service announcements and cautioning new mothers against using cotton swabs to clean their children’s ears.

The study was done at the Center for Injury Research and Policy at the Research Institute at Nationwide Children’s Hospital, the Ohio State University College of Medicine and the Department of Pediatric Otolaryngology-Head and Neck Surgery at Nationwide Children’s and Wexner Medical Center at Ohio State University.

It was limited by the lack of details in some emergency department reports and authors say that the number and severity of injuries likely is higher because only children who visited emergency departments were analyzed. Further, data was not available for years past 2010.

Raman said she isn’t taking any more chances. The family doesn’t use cotton swaps for cleaning their ears.

“The consequences are high,” Raman said. “You think it’s not a big deal, but it can be.”